NPIMap

Organization Active NPI

Tidalhealth Specialty Care, LLC

  • Cardiovascular Disease Physician
  • Salisbury, MD
National Provider Identifier
1053936906
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
TIDALHEALTH SPECIALTY CARE, LLC
Practice address
106 Milford St
Salisbury, MD 21804-6953
Phone
(410) 334-2227
NPI assigned
Jun 16, 2020
Organization subpart
Yes
Parent organization
TIDALHEALTH SPECIALTY CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
William Pelot
Title
Chief Administrative Officer
Phone
(410) 543-7497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

106 Milford St
Salisbury, MD 21804-6953

Mailing address

PO Box 825461
Philadelphia, PA 19182-5461

Other practice location 1

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 912-6400

Other practice location 2

400 Eastern Shore Dr
Salisbury, MD 21804-5513
Phone (410) 749-8906

Other practice location 3

801 Middleford Rd
Seaford, DE 19973-3636
Phone (302) 629-6611

Other practice location 4

200 Federal St
Seaford, DE 19973-5764
Phone (302) 629-3251

Other practice location 5

9733 Healthway Dr
Berlin, MD 21811-1155
Phone (410) 334-2227

Other practice location 6

11107 Cathage Road
Suite 201
Berlin, MD 21811-2156
Phone (410) 629-0888

Other names 1

  • TidalHealth Cardiology Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0967455Tidalhealth Cardiology- Salisbury South106 Milford Street Suite 605, Salisbury, MD 21804Certificate of waiverNov 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Tidalhealth Specialty Care98 organizations share this tax ID, including this one
Part of
Tidalhealth Specialty Care

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

106 Milford St
Salisbury, MD 21804
Phone (410) 334-2227

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1053936906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825461",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046953",
            "telephone_number": "410-334-2227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Carroll St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218015422",
            "country_code": "US",
            "telephone_number": "410-912-6400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Eastern Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218045513",
            "country_code": "US",
            "telephone_number": "410-749-8906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Middleford Rd",
            "address_purpose": "LOCATION",
            "city": "Seaford",
            "state": "DE",
            "postal_code": "199733636",
            "country_code": "US",
            "telephone_number": "302-629-6611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Federal St",
            "address_purpose": "LOCATION",
            "city": "Seaford",
            "state": "DE",
            "postal_code": "199735764",
            "country_code": "US",
            "telephone_number": "302-629-3251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9733 Healthway Dr",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "MD",
            "postal_code": "218111155",
            "country_code": "US",
            "telephone_number": "410-334-2227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11107 Cathage Road",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "MD",
            "postal_code": "218112156",
            "country_code": "US",
            "telephone_number": "410-629-0888",
            "fax_number": "410-629-1993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TIDALHEALTH SPECIALTY CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TIDALHEALTH SPECIALTY CARE, LLC",
        "enumeration_date": "2020-06-16",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "PELOT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "410-543-7497"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TidalHealth Cardiology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "TidalHealth Cardiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.